Ems Unit Check Sheet

• Shift readiness check sheet

• TAFB

• Prepared by

Arrival

• Who is the paramedic for this shift

  Select Curtis Brubaker Mike Hopkins Megan Koenig Chris Paoli Jason Pittman Harrison Walter

  • Curtis Brubaker
  • Mike Hopkins
  • Megan Koenig
  • Chris Paoli
  • Jason Pittman
  • Harrison Walter

• Who is the EMT for this shift

  Select Eric Berryman Luke Koenig Andrew Olson Michael Rice Travis Rosson Ashley Shear

  • Eric Berryman
  • Luke Koenig
  • Andrew Olson
  • Michael Rice
  • Travis Rosson
  • Ashley Shear

• Select date

  Date

• Are both crew members present in proper attire?

  yes

  no

• Did off going crew have a call that prolonged shift checkout?

  yes

  no

• Is EMS unit clean and stocked

  yes

  no

• If not please explain

• Is station clean ie floors swept and mopped, trash taken out, and truck bay tidy.

  yes

  no

• If not please explain

• Which truck are you in today?

  Select truck 608 truck 609 truck 610

  • truck 608
  • truck 609
  • truck 610

• Mileage

• Is there any new damage noticed? If so please photograph in next option

  yes

  no

• Add media

  Media

• Are there any malfunction indicators present ie check engine light, battery light, or abnormal gauge activity?

  yes

  no

• Motor oil is checked while engine is off and has been off for at least one minute, is the level:

  Select FULL OK LOW NOT REGISTERED

  • FULL
  • OK
  • LOW
  • NOT REGISTERED

• The coolant level can be seen through the bottle on the driver side of the engine compartment. What level does the coolant level appear to be?

  FULL

  OK

  LOW

  NOT REGISTERED

• Truck starts and runs well?

  yes

  no

• The brake fluid can be checked by seeing through the brake fluid reservoir next to the coolant level bottle. Is the brake fluid at an adequate level?

  Select FULL OK LOW NOT REGISTERED

  • FULL
  • OK
  • LOW
  • NOT REGISTERED

• The transmission fluid is checked via a long dipstick that is located near the center of the engine compartment, closer to the passenger side. The dipstick handle is yellow and says "trans fluid" on it. The transmission fluid is check while the engine is idling in park on a level surface. The trans fluid level is:

  FULL

  OK

  LOW

  NOT REGISTERED

• Front tire pressures checked (target pressure 75 PSI)

• Rear inner and outer tire pressures checked (target pressure 75 PSI)

• Front left tire pressure before adjustments were made

• Front right tire pressure before adjustments made

• Right rear outer tire pressure before adjustments were made

• Right rear inner tire pressure before adjustments were made

• Left rear outer tire pressure before adjustments were made

• Left rear inner tire pressure before adjustments were made

• Onboard oxygen supply present and leak free.

• Onboard oxygen pressure

• Headlights functioning

• Turn signals functioning

• Brake lights functioning

• Emergency lights functioning

• Scene lights functioning

• Patient compartment lights functioning

• All heating and air conditioning functioning

Supplies

• Thomas pack present, clean, and stocked, checked for expired drugs

• Oxygen bag present, clean, stocked and checked for expired supplies

• Portable oxygen pressure

• Cardiac monitor present charged and stocked with electrodes

• Tablet and wifi card present and functioning

• Is any new damage noticed? If so please photograph in next option.

• Add media

  Media

• 10 IV catheters of each size present

• 10 profiled saline flushes present

• 10 1000ml NS IV bags present

• 10 drops/ML drop administration sets present

• 2 sterile water bottles present

• 10 saline locks present

  Media

• 2 60 drops/ML sets

• 10 IV start kits present

• 10 10ML syringes present

• 10 transfer needles present

• 10 3ML syringes present

• 5 1ML syringes present

• 5 nebulizers present

• 5 adult non rebreather a present

• 3 pediatric non rebreathers present

• 2 infant non rebreathers present

• 4 adult nasal cannulas present

• All endotracheal tubes sizes present

• 2 types each of Stylettes present

• All OPA sizes present

• All NPA sizes present

• 3 French suction catheters present

• 3 yaunkers hard suction tips present

• 3 suction tubing sets present

• 2 extra suction basins and lids present

• Vent circuit present

• CPAP circuit present

• CPAP machine present

• Ventilator present

• 50+ 4x4 bandages, 6 rolls Curl-x, 2 eye patches, 2 eye shields, and 2 bottles of peroxide present.

• SAM splint x 2, CAT tourniquet x 2 present, 10 triangle bandages, 10 ABD mini pads present.

• 2 large ABD pads present.

• Manual BP cuff and multi cuff system bag present.

• Airway drug bag present with medications and cold cold packs present.

• Add signature

  Sign